THE ranks of public healthcare’s administrative staff increased 12% in the three years to September last year, even as the number of doctors and nurses flatlined, Treasury figures show.
The data are in line with a recent analysis by the Development Policy Research Unit at the University of Cape Town, which found that the government went on a recruitment drive after 2008 in which low-level clerks were among the primary beneficiaries.
The Treasury’s data show the number of "core administrative" staff employed by the public health sector rose from 33,331 to 37,336 between 2012 and last year. The number of doctors shrank 0.03% from 19,422 to 19,352 and nurses rose 3% from 134,453 to 136,439 in the three-year period. This translates into two administrative staff for every doctor employed by the state.
"There’s no good explanation for the increase in administrative posts," said Rural Health Advocacy Project spokesman Daygan Eagar.
"There has been such worry about accountability that administrative staff have been hired to rectify perceived problems, but it has just added red tape, increased inefficiency and hasn’t dealt with corruption," he said.
Health officials’ insistence on following the Public Finance Management Act to the letter had resulted in waste and inefficiency, he said, citing a recent example in the Eastern Cape where officials insisted on procuring strips for glucometers from the cheapest possible supplier although they were incompatible with the devices that had already been purchased. Glucometers are used to measure blood sugar.
"This is not malicious compliance. It’s people who don’t feel confident to use their discretion," he said. "Compliance is seen as so important it is to the detriment of the delivery of services."
Mr Eagar said the project welcomed Finance Minister Pravin Gordhan’s assurance that frontline healthcare staff would be spared in the state’s drive to cut the public sector wage bill by R7.2bn in the next three years.
The government plans to cut as many as 20,000 jobs and will impose a "lock" on its payroll system to prevent provincial departments making unapproved new hires.
But he expressed concern that provincial health departments might cut clinical positions "by stealth", for example by delaying filling vacant posts when medical professionals quit.
"Any talk of reducing the size of the staff establishment is worrying. Administrative staff are the least likely to leave, you can’t rely on attrition to reduce their numbers. Healthcare workers move all the time. The real test will be in how they get the administrative numbers down."
LIFEBLOOD: The number of nurses in the public health sector increased 3% in the three years to last year, according to the Treasury. Picture: DAILY DISPATCH
THE ranks of public healthcare’s administrative staff increased 12% in the three years to September last year, even as the number of doctors and nurses flatlined, Treasury figures show.
The data are in line with a recent analysis by the Development Policy Research Unit at the University of Cape Town, which found that the government went on a recruitment drive after 2008 in which low-level clerks were among the primary beneficiaries.
The Treasury’s data show the number of "core administrative" staff employed by the public health sector rose from 33,331 to 37,336 between 2012 and last year. The number of doctors shrank 0.03% from 19,422 to 19,352 and nurses rose 3% from 134,453 to 136,439 in the three-year period. This translates into two administrative staff for every doctor employed by the state.
"There’s no good explanation for the increase in administrative posts," said Rural Health Advocacy Project spokesman Daygan Eagar.
"There has been such worry about accountability that administrative staff have been hired to rectify perceived problems, but it has just added red tape, increased inefficiency and hasn’t dealt with corruption," he said.
Health officials’ insistence on following the Public Finance Management Act to the letter had resulted in waste and inefficiency, he said, citing a recent example in the Eastern Cape where officials insisted on procuring strips for glucometers from the cheapest possible supplier although they were incompatible with the devices that had already been purchased. Glucometers are used to measure blood sugar.
"This is not malicious compliance. It’s people who don’t feel confident to use their discretion," he said. "Compliance is seen as so important it is to the detriment of the delivery of services."
Mr Eagar said the project welcomed Finance Minister Pravin Gordhan’s assurance that frontline healthcare staff would be spared in the state’s drive to cut the public sector wage bill by R7.2bn in the next three years.
The government plans to cut as many as 20,000 jobs and will impose a "lock" on its payroll system to prevent provincial departments making unapproved new hires.
But he expressed concern that provincial health departments might cut clinical positions "by stealth", for example by delaying filling vacant posts when medical professionals quit.
"Any talk of reducing the size of the staff establishment is worrying. Administrative staff are the least likely to leave, you can’t rely on attrition to reduce their numbers. Healthcare workers move all the time. The real test will be in how they get the administrative numbers down."
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